This study will evaluate the efficiency of dietary intervention on intradialytic weight gain. Uniric hemodialysis patients without serious dietary complications, who accumulate above 2.5 kg (or above 4%) of their dry weight, will undergo a series of dietary consultations for sodium restriction. One month after the intervention, their intradialytic weight accumulation will be measured.
Inter Dialytic Weight Gain (IDWG) ascribed to fluid retention is one of the major clinical problem that patients in hemodialysis need to cope with between 2 subsequent hemodialysis especially in patients with no residual renal function. Fluid retention is associated with morbid conditions such as lower-extremity edema, ascites, pulmonary vascular congestion or edema, hypertension, and worsening heart failure. Gain weight above 2 kg between 2 subsequent hemodialysis found to be in higher risk of all-cause mortality and cardiovascular death .Lowering daily sodium intake found to mitigate fluid retention ,however there are only a few researches that check it. 2IDWG also associated with poorer quality of life. Dietary sodium restriction recommendation since the beginning of hemodialysis are based on association of this restriction with balance of hypertension and fluid retention. Sodium intake recommended for patients in hemodialysis is limited to 2 grams a day. Nevertheless, there are only a few studies that examine the efficiency of this restriction because of the complexity of measurement of sodium intake. One recently published study which used a 24-h recall to measure sodium intake, found a direct correlation between IDGW and mortality form any reason. In spite of this complexity, IDWG has been found to be in a direct relation with patients' nutrition status. One of sodium-related issues is malnutrition. Malnutrition in dialysis is a risk factor for patients' morbidity and mortality. Higher sodium intake is associated with higher calorie and protein intake, while adherence to restriction of sodium intake is poor in hemodialysis. This is a reason for high importance to study effects of sodium restriction in people with more than 2.5 kg (or 4% of dry body weight) IDWG while following up their nutritional status
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Dietary consultation for sodium restriction to decrease dietary intake to 2 grams/day less than the patients consume currently
Reduction in intradialytic weight gain (IDWG)
Reduction in the weight gain at 2 subsequent hemodialysis in KG/
Time frame: between baseline and 6 weeks
dietary sodium intake.
as measured by food recall assesment
Time frame: at baseline and 6 weeks
Change in CRP values
Time frame: between baseline and 6 weeks
Changes in subjective global assesment (SGA)
SGA is a nutritional assesment measure
Time frame: between baseline and 6 weeks
change in predialysis blood pressure
Time frame: between baseline and 6 weeks
Changes in quality of life
assessed by SF 36
Time frame: between baseline and 6 weeks
number of hypotensive episode during dialysis
define as drop of more than 20 mm hg systolic blood pressure from baseline
Time frame: at baseline and 6 weeks
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